Are Your Feelings About Money Sabotaging Your Business?

Are you a therapist? Do you have complicated feelings about money? 

Whether you feel somewhat uncomfortable discussing money or actively avoid discussing financial matters as much as possible, you are far from alone. But your discomfort around the topic could be hurting the growth and success of your private practice. In order to maintain a thriving private practice, you must feel comfortable charging fees that allow you to make a living. 

Why Finances Prompt Strong Feelings

Money is a sensitive subject for many people, given our culture’s pervasive shaming around the subject. Having too much money, making too little money, needing more money…any of these financial situations has some cultural baggage tied to it. People in the business of helping others may have an even harder time discussing—or thinking about—money. Many people feel as if they seem greedy when asking for money, even when that money is payment for a service they’ve provided. 

As a therapist, you want to help people grow, work through struggles, and heal from past challenges and trauma. You’ve likely learned from your education and clinical experience that financial insecurity contributes to anxiety and distress for many. If you’ve experienced financial hardship yourself, you may have even more guilt about the fees you charge for therapy. You might want to set the lowest possible rate you can accept to make therapy more accessible.

You could also believe you haven’t earned the right to charge a higher rate. Maybe you worry you’ll lose potential clients if your session fee is too high, or you believe it’s unfair to charge so much when you love your work. Or perhaps you prioritize and specialize in working with lower-income clients or people coming from disadvantaged backgrounds, and you don’t want to turn away anyone who needs help they can’t afford.  

You Deserve to Be Paid

It’s tough to unpack and reconcile complex ideas about money with your own desire to succeed as a professional. If you have a hard time raising your rates, find yourself offering clients a discount (even when you can’t really afford it), or have a lot of guilt around the amount you charge for therapy, it’s important to remind yourself of these key facts:

You may worry your fees might present financial hardship for your clients or that charging too high of a rate would lead some clients to avoid seeking therapy. While it’s true some clients may not be able to afford higher rates, it’s also true many more clients can afford those fees and will pay them. 

If you’re concerned about your ability to offer support to people in financial need, consider that setting a firm rate for most clients will allow you to see one or two clients at a lower rate each week. 

You have financial burdens too. Rent, mortgage, power and utilities, phone bills—your monthly expenses probably aren’t too dissimilar from those of your clients. In order to take care of these things and other necessities like food and clothing (not to mention self-care and quality-of-life expenses) you must charge a rate that allows you to make a living. Otherwise the anxiety and money stress that results could contribute to job dissatisfaction and burnout.

Charging What You Need

You may have heard from professional colleagues, advice columns speaking to new therapists, or other sources that you should, “charge what you’re worth.” 

“Okay,” you think. “Charge what I’m worth. So how do I measure my worth?”

Worth is difficult to determine, especially because the value of your services could vary greatly between clients. If you offer a very specialized type of treatment, you may be worth a lot more to someone seeking that approach. But this specialty won’t matter at all to someone who’s just looking for any therapy available. 

Furthermore, the fee you charge has very little to do with your skill. Plenty of therapists who charge high fees have only a year or so of practice experience. They may treat only one mental health issue or offer a single type of therapy. Similarly, many therapists who charge lower fees may have extensive training and expertise and offer a wide range of approaches. 

A therapist’s fee is determined by many factors beyond skill, including office location, the population served, and so on. While it may seem like a good idea to check out what other providers in your area charge and set a comparable session fee, this isn’t necessarily the best approach. Your private practice fees shouldn’t be determined by the fees of other therapists. Instead, review your personal day-to-day expenses, business operation costs, and financial goals. 

Online calculators and worksheets specifically designed for private practice therapists can be very helpful here. These tools can help you determine the lowest rate you’re able to charge to meet your personal financial needs and sustain your desired quality of life. This rate could end up resembling the rate charged by other therapists in your area, but that’s not guaranteed. The point of a budget is not to make you “fit in” with your peers, but instead to help you manage your business.

Therapy is Valuable

If your rate seems high to you, consider whether you might be underselling your own worth. This is especially likely if you are a member of a marginalized group. Therapy is a female-dominated profession. According to 2016 statistics from the American Psychological Association, 65% of practicing psychologists were women, while 16% were racial and ethnic minorities. 

Our culture often devalues the work done by women and minorities. Marginalized employees often receive less compensation for doing the same job as privileged employees. If a certain occupation is filled with women or minorities, that line of work may be dismissed as less valuable or requiring less skill than similar jobs. While these beliefs are entirely false, people may still internalize them, eventually coming to doubt the value of their work.

But therapy is valuable. For many people, it’s an essential component of health care, as vital to their well-being as vaccinations or physical rehab. As a therapist, you support people in a way that no one else can. By charging too-low rates, you don’t simply undermine your success as a therapist. You may also be attaching a lower value to therapy.  

People seeking therapy want a therapist they can connect with and trust, a compassionate professional who will help them heal and grow. If you can provide this guidance and care, then they will value what you offer at the price you set. 

If you would like more professional resources on creating a budget and optimizing your practice, consider getting a GoodTherapy membership.
 
References:

1. Adams, S. (2016, January 21). Private practice owners: How to set session fees your clients can actually afford…and still make a profit. Retrieved from https://www.linkedin.com/pulse/private-practice-owners-how-set-session-fees-your-clients-adams
2. Armstrong, S. (2018, May 30). Setting fees: What most therapists don’t know about price. Therapy Marketing Institute. Retrieved from https://therapymarketinginstitute.com/setting-fees-what-most-therapists-dont-know-about-price
3. Babic, M., & Gault, B. (2016, November 30). Column: The economy undervalues ‘women’s work,’ and that needs to change. PBS. Retrieved from https://www.pbs.org/newshour/economy/column-economy-undervalues-womens-work-needs-change
4. Friedman, L. (2019, July 1). Setting fees in psychotherapy. Retrieved from https://www.drlynnfriedman.com/setting-fees-in-psychotherapy
5. Lin, L., Stamm, K., & Christidis, P. (2018). 2007-16: Demographics of the U.S. psychology workforce. American Psychological Association. Retrieved from https://www.apa.org/workforce/publications/16-demographics/index
6. Stevens, L. (1998). Two ways to make your fee policies clear and easy to talk about. Psychotherapy Networker. Retrieved from https://www.psychotherapynetworker.org/blog/details/1402/when-money-comes-up-in-therapy